A recently published study in the Archives of Neurology suggests that vascular imaging is justified in the case of young adults (ages 18 to 45) with stroke symptoms.
Some recent studies have shown that stroke incidence is increasing among this age group. For example, an article in the Annals of Neurology from September 2011 reported that between 1995 and 2008, ischemic stroke incidences among males between 25 and 44 increased by 50 percent, while the incidence among males ages 15 to 34 years old rose by 46 percent.
The researchers, led by Ruijun Ji, M.D., Ph.D., of the department of neurology at Massachusetts General Hospital, retrospectively reviewed 215 patients ages 18 to 45 with ischemic stroke/transient ischemic attack in order to investigate the yield of diagnostic tests, neuroimaging findings and other treatments. Among their findings was that relevant abnormalities were shown on cerebral angiography in 136 of 203 patients, on cardiac ultrasonography in 100 of 195 patients, on Holter monitoring in 2 of 192 patients, and on hypercoagulable panel in 30 of 189 patients.
Multiple infarcts were seen in 31 percent of the patients and were more prevalent in those adults younger than 35. In addition, relevant arterial lesions were detected in the middle cerebral artery (23 percent), internal carotid artery (13 percent) and vertebrobasilar arteries (13 percent). Cardioembolic stroke occurred in 47 percent to the cases.
According to a Health Imaging article, the authors suggested that the high diagnostic yield of vascular imaging "justif[ies] routine cerebrovascular imaging in young adults with stroke-like symptoms."